I now have a plan for people diagnosed with HBP,HC, or diabetes who can sign up during lock-in. It puts many of the brand-name meds for those conditions at a generic price. The inpatient hospital is a little higher as well as the outpatient surgery along with $10 co-pay for primary doc and $40 for a specialist. Anyone who has our state's prescription help has one SEP available. It's keeping me fairly busy.
I now have a plan for people diagnosed with HBP,HC, or diabetes who can sign up during lock-in. It puts many of the brand-name meds for those conditions at a generic price. The inpatient hospital is a little higher as well as the outpatient surgery along with $10 co-pay for primary doc and $40 for a specialist. Anyone who has our state's prescription help has one SEP available. It's keeping me fairly busy.
I think you may talking about Secure Horizons EverCare Plan (or something comparable to it)...
Chronic Condition 1 SEP for Lifetime
Drug Subsidy to Dual Eligible Unlimited SEP for Lifetime
There are numerous SNP plans out there that are keeping us busy.
Evercare looks like a good plan, but they have no network in KC.
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"Government's view of the economy could be summed up in a few short phrases: If it moves, tax it. If it keeps moving, regulate it. And if it stops moving, subsidize it." Ronald Reagan
Coventry's Diabetic and Cholesterol PPO - it is a local PPO available in 6 counties around Kansas City
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"Government's view of the economy could be summed up in a few short phrases: If it moves, tax it. If it keeps moving, regulate it. And if it stops moving, subsidize it." Ronald Reagan
There are numerous SNP plans out there that are keeping us busy.
Evercare looks like a good plan, but they have no network in KC.
Actually they do. Evercare has an SNP (PPO) for both Chronic Illness and Dual Eligibles in Johnson and Wyandotte counties in Kansas. And the specific illnesses are over 8, which is fairly generous. Unfortunately, the rest of the state is without.
They cover Missouri best with about 20 counties split between the St. Louis area and Springfield area, leaving the KC market out at this time.
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To be truly independent, an agent should not be dependent on a government bureaucrat for contracts or commissions.
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"Government's view of the economy could be summed up in a few short phrases: If it moves, tax it. If it keeps moving, regulate it. And if it stops moving, subsidize it." Ronald Reagan
SNPs are set in concrete for the time being. A moratorium has been enacted through 2009 on the expansion of any areas not covered on 1/1/08, so what you see is what you get.
As a matter of fact, Evercare was supposed to offer an Institutionalized SNP (Nursing Home) plan by April or May in Kansas. I guess that is not going to happen now.
I may be wrong, but I think the SNP benefits will enlarge to encompass more disease states, i.e. illnesses. As it stands, CIP only covers 4 while Evercare covers 8. My information leads me to believe this will be considerably expanded with the 2009 SNP benefit plans.
Last edited by retread : 04-23-2008 at 09:35 PM.
Reason: add info
Unless carriers stop paying compensation for new business.
Effective May 12, 2008, WellCare will only compensate producers for Duet sales in Arkansas, Hawaii, Idaho, Iowa, Ohio, Utah, Virginia, Washington and West Virginia.
Unless carriers stop paying compensation for new business.
Effective May 12, 2008, WellCare will only compensate producers for Duet sales in Arkansas, Hawaii, Idaho, Iowa, Ohio, Utah, Virginia, Washington and West Virginia.
Just got the Wellcare email saying that Missouri and Kansas are out on the duet plan.
Looks like Humana will get my duels...
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"Government's view of the economy could be summed up in a few short phrases: If it moves, tax it. If it keeps moving, regulate it. And if it stops moving, subsidize it." Ronald Reagan
This is just the start, if advantage plans stick around we agents are going to be out! We should be lobbying against them, they are not in the best interest of the retiree.
Any plan that is regulated so highly by the government is not going to be good for the consumer.
I mentioned in another post that Standardazation was the worst thing to happen to Med Supps. When you take competition out of anything what happens to the product, it gets stymied!
If you are mainly in the senior business just read the Medicare handbook, it tells how the consumer can purchase Part C plans and nothing is mentioned about an agent....
This is just the start, if advantage plans stick around we agents are going to be out! We should be lobbying against them, they are not in the best interest of the retiree.
Any plan that is regulated so highly by the government is not going to be good for the consumer.
I mentioned in another post that Standardazation was the worst thing to happen to Med Supps. When you take competition out of anything what happens to the product, it gets stymied!
If you are mainly in the senior business just read the Medicare handbook, it tells how the consumer can purchase Part C plans and nothing is mentioned about an agent....
I think you are onto something here. I learned the futility of trying to sell stand-alone PDPs this last AEP. Every PDP carrier has online application at pharmacies everywhere. They even present comparisions between other PDP plans which is forbidden for us agents to do, but their programs are given approval by CMS.
The last straw is the compensation... $5 for one carrier's PDP enrollment! That doesn't even pay for the gas to go to the pharmacy to sit around and try to sign-up people. Even with the so-called pharmacist participation program, I have yet to find a pharmacy interested in my help. This just may be my area, others of you out there may have a different response. If you do, I would like to know.
My point is: I think Dandan is right. This is a future possibility with MA plans. For one thing, the baby-boomers coming into the picture are computer savvy, unlike the previous generation. They will simply log-on and sign-up without the need for an agent. If they make a poor choice, they have a second chance for a do-over, etc.
CMS is clarifying for CY 2009 that direct marketing activities constitute contact with an eligible Medicare beneficiary or individual acting on behalf of the beneficiary that serves to promote the choice of a Part D sponsor’s or MAO’s benefit plans through advice and counseling, but does not include the following that may be provided by customer service representatives: the provision of factual information that is available publicly on plan characteristics, the fulfillment of a request for plan materials, or the taking of demographic information.
Based on this clarification, MAOs and PDP sponsors may not require potential enrollees to interact with a licensed agent in order to obtain plan materials or to enroll in a plan if the enrollee is not asking for advice or counseling. A Customer Service Representative may fulfill a request for plan materials, including an enrollment form, and accept inbound, telephonic enrollments on behalf of enrollees who have already decided to enroll in a particular plan.
How do ya like that. No license and no 48 hours to cool off!
I can see it now! We drive 2 hours and interview for an hour and cool off for 48 hours. We also leave a brochure that has the home office 800#'s and carrier contact information on every page. Our client is itching to get it done now and calls the carrier for a drug look-up. Bingo!
Due to our FREE advice and counseling the home office signs them up. And we all know they have been, and will be -- sold by the home office. Good thing CMS is looking out for the senior! This should help the carriers bottom line.
Maybe, instead of a 48 hour cool off we should be required to take a cold shower! I think that's in the NEW CMS marketing rules due out soon.
I do not think that MA plans are going to go away. Maybe some duel elig based plans, but the local PPO and HMO plans are still very strong on the market.
With people enrolling though state agencies, I would not worry about that. The majority of people I have met with that have gone through a counselor, come out more confused then when they went in.
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"Government's view of the economy could be summed up in a few short phrases: If it moves, tax it. If it keeps moving, regulate it. And if it stops moving, subsidize it." Ronald Reagan
Yuck... I have learned to black out company numbers and address and put my contact info over it with a sticky label for other insurance plans... too bad we cant do that with Medicare Stuff, it would make life easier
Last edited by theinuranceguy : 04-26-2008 at 12:48 AM.
Re: Medicare Advantage Plan
CMS marketing rules due out soon.
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